Lecture 3

Question 1

Should patient’s in the acute phase have bed rest?

What should we encourage?

What treatments are most beneficial if used early

Answer 1

No, if possible, if severe atleast less than 2 days

Early motion, WALKING

manual therapy is most benefcial used early in patients without radiating pain

Question 2

What are the goals of the acute phase

Answer 2

Decreased pain, inflammation, spasm

Promote tissue healing

increase pain free ROM

regain soft tissue extensibility

regain NM control

Question 3

What are the goals of the subacute phase

Answer 3

Acheive significcant decrease in symptoms of acute resolution of pain

restore full pain free ROM

full integration of upper and lower kinetic chains

restoration of respiratory function

Question 4

Research suggests that the _______ phase is critical in preventing chronicity and disability

Answer 4

subacute

Question 5

What is chronic pain

Answer 5

Pain in the absence of tissue damage

Question 6

What is primary hyperalgesia

secondary hyperalgesia

Answer 6

primary- normal pain due to tissue damage

secondary- adaptation in CNS, increased responsiveness to stimuli from periphery

Question 7

What is central sensitization

Answer 7

functional changes in CNS due to chronic pain

altered sensory processing

malfunctioning of descending anti-nociceptive mechanisms

increased activity of pain pathways

Question 8

The Chicago roll/ million dollar roll mainly works on what part of the spine?

Where do you apply pressure down?

Answer 8

SI joint

ASIS

Question 9

T or F: Direction-specific exercises/mckenzie exercises are tissue specific

Answer 9

F

Question 10

How often should a patients preform their extension direction specific exercises

Answer 10

20 times per hour while awake

Question 11

If a patient has lateral shift, can they still do extension/flexion repeated motions

Answer 11

No the lateral shift must be corrected first

Question 12

How often should patients preform their flexion repeated motion exercise

Answer 12

6-10 times per hour they’re awake

Question 13

How many reps of nerve glides should a patient do

Answer 13

1 set of 10-15 reps in initial session to avoid irritating nervous tissue

Question 14

T of F: majority of evidence supports passive modalities for back pain

Answer 14

F

Question 15

What is the proposed progression for treatment sessions

Answer 15

1. Manual techniques
2. Mobility exercises
3. Neuromuscular education
4. Strength training
5. Functional/therapeutic activity tolerance

Question 16

T or F: when educating LBP patients you should emphasis anatomy

Answer 16

F

Question 17

T or F: Patients with LBP should return to normal activities asap

Answer 17

T

Question 18

You should use _____ manipulation techniques for acute LBP

You should use thrust and nonthrust techniques for subacute and chronic LBP

Answer 18

Thrust

Question 19

Joint manipulation contraindications

Answer 19

Presence of serious pathology

PT skill/experience

Fracture

Ligament rupture

No working hypothesis

Worsening neurological function

Unremitting night pain

Severe multidirectional spasm

UMN lesions

Question 20

Is there clear evidence that Dry needling helps patients with LBP

Answer 20

No

May consider this for subacute

Not effective than any other modality for acute

Question 21

When is surgical intervention warranted

Answer 21

Cauda equina

B&B disturbances

Onset or progression of significant motor deficit

Significant instability (spondy 4 or 5)

Progression of spinal deformities (curve over 45)

Symptoms do not improve in X amount of time

Question 22

What is the most common diagnosis that results in a lateral shift

Answer 22

Herniated Disc

Question 23

How do you differentiate between opening a closing issues?

Answer 23

Problem w/ spinal flexion - opening issue

Problem w/ spinal extension - closing issue

Then from here you can figure out which side opening or closing